New research has found that young children with type I diabetes (T1D) have slower brain growth compared to children without diabetes.
The new study, published in Diabetes, suggests that continued exposure to hyperglycemia, or high blood sugars, may be detrimental to a child’s developing brain.
“Our results show the potential vulnerability of young developing brains to abnormally elevated glucose levels, even when the diabetes duration has been relatively brief,” said Nelly Mauras, M.D., of Nemours Children’s Clinic in Jacksonville, Florida, and lead author of the study.
Mauras and her colleagues in the Diabetes Research in Children Network (DirecNet), which includes five clinical pediatric diabetes centers and a coordinating center, studied brain development in children ages four to nine with T1D.
The researchers used structural magnetic resonance imaging (MRI) and cognitive tests to determine if abnormal blood glucose levels impact brain structure and function at a young age. The children also underwent blood sugar monitoring using continuous glucose sensors.
The researchers found that the brains of children with diabetes showed slower overall and regional growth of gray and white matter compared to children without diabetes. These changes were associated with higher and more variable blood sugar levels, the researchers noted.
Although there were no significant differences in cognitive function between the groups after 18 months, the brain imaging results suggest that the children with T1D had differences in brain maturation compared to children without diabetes.
Some of the brain regions impacted are involved in visual-spatial processing, executive functions, and working memory.
“Despite the best efforts of parents and diabetes care team, about 50 percent of all blood glucose concentrations during the study were measured in the high range. Remarkably, the cognitive tests remained normal, but whether these observed changes will ultimately impact brain function will need further study,” said Mauras.
“As better technology develops, we hope to determine if the differences observed with brain imaging can improve with better glucose control.”
“This is the thing that parents always worry about when it comes to a child with a chronic illness,” said study co-author Karen Winer, M.D., pediatric endocrinologist at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health (NIH).
“Does it affect their brain? The good news here is that there may be some viable solutions on the horizon that parents should be aware of.”
The research is supported by the NIH, which will continue to fund the research so the researchers can follow these same children through puberty using similar glucose monitoring, cognitive testing and MRI scans, including evaluation of brain function with functional MRI.